Customer Service Representative (Remote)

Keystone Peer Review Organization, Inc.

Job Description
Customer Service Representative Are you an experienced Customer Service Representative looking for a new challenge? Do you value customer service and helping your community? Are you motivated, energetic, and excited to become part of the Kepro team? If so, you might be our next new team member!Who we need:The Customer Service Representative provides all customer service support for the Review Team including but not limited to the following activities: Interacting with beneficiaries and providers via the helpline, creation, formatting and proofreading of letters as well as maintaining timeliness. This position requires a great deal of decision making in regard to more different types of complex appeals.Why us?Kepro is a rapidly growing national quality improvement and care management organization. We work to ensure that over 20 million people receive the right care, at the right time, in the right setting. People Focused. Mission Driven.Shape the future of healthcare with us. We are mission driven to improve lives through healthcare quality and clinical expertise.We do this through our people.At Kepro, you can do meaningful work that makes a real difference for the lives of individuals across the country. We are an organization that cares deeply about our employees and we provide the training and support to do the best work of your career.Benefits are a key component of your rewards package at Kepro. These benefits are designed to provide you and your family additional protection, security, and support for both your career and your life away from work. They are comprehensive and fit a variety of needs and situations. Our benefits include comprehensive health plans, paid time off, retirement savings, corporate wellness, educational assistance, corporate discounts and more.What you'll do: Responsible for typing/merging, proofing for clarity, printing, and mailing correspondence. Communicate verbally and in writing with external customers to furnish and request review information. Foster effective working relationships between Kepro's internal and external customers. Assist with and participate in Review Team in identifying areas for potential improvement, as noted on case reviews and process. Answer the Beneficiary Helpline through the utilization of the hunt group and available light functions. Determine how to best assist caller either by a service offered by Kepro or by referring them to an external agency and properly enter referral into CMS system. All letters sent out in timely manner with correct components included and reviewed for grammatical and spacing errors. Get and validate notices and all components of medical records. Provide intake for all appeals received by Kepro. Proficient in customer service guidelines and standards. Utilize internal quality control tools to assess individual work and team processes. What you'll need:Qualifications High school diploma or equivalent. Post high school business courses helpful. Medical terminology desired. Knowledge, Skills, Abilities Excellent verbal communication skills, courteous and patient demeanor, must be customer oriented and have the ability to maintain composure under potentially stressful situations. Good grammar, punctuation, spelling, hyphenation, and written communications skills. Customer focused, results oriented and capable of building and maintaining relationships with internal and external customers. Must be flexible and able to work as a team member and support team decisions. General knowledge of a PC based computer system desirable. Knowledge of various software packages with ability to learn additional software packages as needed. Must be able to multi-task and to prioritize assignments. Must have good organizational skills and be able to work independently. Experience Two to three years clerical experience including word processing, various filing systems, and telephone customer service responsibilities. Prior work in a healthcare setting or medical terminology recommended.Previous data entry or other clerical experience is a plus. Thank You!We know your time is valuable and we thank you in advance for applying for this position. Due to the high volume of applicants we receive, only those who are chosen to advance in our interview process will be contacted. We sincerely appreciate your interest in Kepro and invite you to apply to future openings that may be of interest. Best of luck in your search!~ The Kepro Talent Acquisition TeamMental and Physical RequirementsThe physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.Reasonable accommodations will be made as required by law in an attempt to enable an individual with a disability to perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to sit for prolonged periods of time; key and/or control objects; interact extensively with internal and external customers; occasionally lift and/or move objects weighing up to 10 pounds; and occasionally travel within the state.Kepro offers challenging careers, excellent benefits and opportunities for advancement.For consideration, please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please.Visit our website at for more information on the Kepro Family of Companies.EOE AA M/F/Vet/DisabilityKepro is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.